Nokea
The 38-year-old client with chronic asthma is prescribed a leukotriene receptor antagonist. Which is the scientific rationale for administering this medication?
- A. This medication is used prophylactically to control asthma.
- B. This medication will cure the client's chronic asthma.
- C. It will stabilize mast cell activities and reduce asthma attacks.
- D. It will cause the bronchioles to dilate and increase the airway.
Correct Answer: A
Rationale: Leukotriene receptor antagonists (e.g., montelukast) are prophylactic, reducing inflammation to control asthma. They don’t cure, stabilize mast cells, or directly dilate bronchioles.
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When providing discharge teaching to a client with asthma, the nurse will warn against the use of which of the following over-the-counter medications?
- A. Cortisone ointments for skin rashes
- B. Aspirin products for pain relief
- C. Cough medications containing guaifenesin
- D. Histamine blockers for gastric distress
Correct Answer: B
Rationale: Aspirin products for pain relief. Aspirin is known to induce asthma attacks. Aspirin can also cause nasal polyps and rhinitis. Warn individuals with asthma about signs and symptoms resulting from complications due to aspirin ingestion.
The client complains of leg cramps at night. Which medication should the nurse anticipate the HCP ordering to help relieve the leg cramps?
- A. Quinine, an antimalarial.
- B. Soma, a muscle relaxant.
- C. Ambien, a sedative-hypnotic.
- D. Darvon, an opioid analgesic.
Correct Answer: A
Rationale: Quinine is historically used for nocturnal leg cramps, though off-label due to risks. Muscle relaxants, sedatives, or opioids are less specific.
A client with bi-polar disorder is taking lithium (Lithane). What should the nurse emphasize when teaching about this medication?
- A. Take the medication before meals
- B. Maintain adequate daily salt intake
- C. Reduce fluid intake to minimize diuresis
- D. Use antacids to prevent heartburn
Correct Answer: B
Rationale: Maintain adequate daily salt intake. Salt intake affects fluid volume, which can affect lithium (Lithane) levels; therefore, maintaining adequate salt intake is advised.
You are caring for a hypertensive client with a new order for captopril (Capoten). Which information should the nurse include in client teaching?
- A. Avoid green leafy vegetables
- B. Restrict fluids to 1000 cc/day
- C. Avoid the use of salt substitutes
- D. Take the medication with meals
Correct Answer: C
Rationale: Avoid the use of salt substitutes. Captopril can cause an accumulation of potassium or hyperkalemia. Clients should avoid the use of salt substitutes, which are generally potassium-based.
A newly admitted client has a diagnosis of depression. She complains of 'twitching muscles' and a 'racing heart', and states she stopped taking Zoloft a few days ago because it was not helping her depression. Instead, she began to take her partner's Parnate. The nurse should immediately assess for which of these adverse reactions?
- A. Pulmonary edema
- B. Atrial fibrillation
- C. Mental status changes
- D. Muscle weakness
Correct Answer: C
Rationale: Mental status changes. Use of serotonergic agents may result in Serotonin Syndrome with confusion, nausea, palpitations, increased muscle tone with twitching muscles, and agitation. Serotonin syndrome is most often reported in patients taking 2 or more medications that increase CNS serotonin levels by different mechanisms. The most common drug combinations associated with serotonin syndrome involve the MAOIs, SSRIs, and the tricyclic antidepressants.